Thyroid Disease-Pregnancy Complications Link Explored
Increased risk of ICU admission, preeclampsia, and preterm birth linked with hypo/hyperthyroidism
FRIDAY, June 14 (HealthDay News) -- Thyroid diseases are associated with obstetric and labor and delivery complications, but further study is needed to determine if better management of disease during pregnancy is in order, or if it is an intrinsic aspect of thyroid disease that causes poor pregnancy outcomes, according to research published online June 6 in the Journal of Clinical Endocrinology & Metabolism.
Tuija Männistö, M.D., Ph.D., of the National Institutes of Health in Rockville, Md., and colleagues analyzed data for 223,512 singleton pregnancies from the retrospective cohort, the Consortium on Safe Labor.
The researchers found that primary hypothyroidism was associated with increased risk of superimposed preeclampsia (odds ratio [OR], 2.25), intensive care unit (ICU) admission (OR, 2.08), gestational diabetes (OR, 1.57), preeclampsia (OR, 1.47), cesarean section after spontaneous labor (OR, 1.38), preterm birth (OR, 1.34), pre-labor cesarean section (OR, 1.31), and induction (OR, 1.15). Pregnant women with iatrogenic hypothyroidism were at increased risk for placental abruption, breech presentation, and cesarean section after spontaneous labor (OR, 2.89, 2.09, and 2.05, respectively). Hyperthyroidism was linked with increased risk for ICU admission (OR, 3.70), superimposed preeclampsia (OR, 3.64), preterm birth (OR, 1.81), preeclampsia (OR, 1.78), and induction (OR, 1.40).
"Our results indicate that thyroid diseases are associated with significant increases in morbidity during pregnancy, but given that we lacked information on treatment during pregnancy, we were unable to explore whether inadequate treatment was the cause or whether some of the risk is due to thyroid disease itself," the authors write.
Abstract (http://jcem.endojournals.org/content/early/2013/06/05/jc.2012-4233.abstract )Full Text (subscription or payment may be required) (http://jcem.endojournals.org/content/early/2013/06/05/jc.2012-4233.full.pdf+html )